TY - JOUR PY - 2024// TI - Adoption of methadone take home policy by U.S. state opioid treatment authorities during COVID-19 JO - International journal on drug policy A1 - Roy, Victor A1 - Buonora, Michele A1 - Simon, Caty A1 - Dooling, Bridget A1 - Joudrey, Paul SP - e104302 EP - e104302 VL - 124 IS - N2 - BACKGROUND: Patients face well documented problems accessing methadone from opioid treatment programs (OTPs) in the U.S., yet addressing these barriers has proven difficult due in part to the sheer number of actors governing treatment, including state authorities. Changes in federal methadone regulations during COVID-19 offer an opportunity to study the timing and extent of U.S. state opioid treatment authority (SOTA) adoption of policies expanding take home dosing for methadone treatment since March 2020.

METHODS: We completed a policy scan between February 23 and May 2, 2023 on state adoption and subsequent rescinding of federal regulatory exemptions for expanded take-home dosing. This scan involved three components: a policy survey of SOTAs, a freedom of information act (FOIA) request of SAMHSA, and outreach to members of National Survivors Union (NSU)'s methadone work group.

RESULTS: Of the 39 of 50 (78 %) SOTAs that responded, only 2 states (HI and MT) indicated that they never adopted federal exemptions for expanded take-home dosing. Of the 37 adopting states, all adopted the exemptions within the first month after the agency's announcement. Additionally, four SOTAs (OH, IN, FL, MS) indicated that their state subsequently rescinded expanded take-home dosing for methadone.

CONCLUSIONS: Among responding states, regulations expanding take-home dosing appear to have been adopted by U.S. SOTAs in a widespread and rapid manner at the start of the COVID-19 pandemic, but some states have begun to rescind such policies. Our findings suggest that state regulators can rapidly modify OTP regulations in response to federal policy changes. SOTA policies are likely to become critical factors in the adoption of methadone treatment innovations if new federal regulatory flexibilities become permanent.

Language: en

LA - en SN - 0955-3959 UR - http://dx.doi.org/10.1016/j.drugpo.2023.104302 ID - ref1 ER -